Although it remains rather a taboo subject, vaginal dryness can happen at any time in a woman’s life but is more likely to occur during perimenopause and postmenopause. Vaginal Dryness is one of the most common, upsetting, irritating symptoms and one which needs to be talked about more freely.
Vaginal Dryness Menopause – abnormal dryness of the vagina, caused by a lack of natural lubrication.
Vaginal Atrophy – (Atrophic Vaginitis) is inflammation of the vagina and the outer urinary tract.
You have reached menopause when you have not had a period for a full 12 months. From then on you are in the postmenopause phase of your life.
In addition to vaginal problems, you may experience other symptoms such as hot flushes and night sweats, irregular periods, loss of libido and mood changes.
If you are not experiencing other menopause symptoms at the same time as vaginal dryness you need to seek a physical examination by your Healthcare Professional to rule out other causes.
As your estrogen levels decline your vaginal walls become thinner, dry and less elastic. Your body naturally lubricates the vaginal walls with a thin layer of moisture. the moisture layer is made of a clear fluid emitted through the blood vessel walls around the vagina. When you are sexually aroused, the blood vessels receive more blood flow stimulating the secretion of fluids resulting in an increase in vaginal lubrication. Hormone changes that occur with menopause can disrupt this process.
Your vagina may “atrophy” and become small in width and length. This symptom can appear in a sudden drop in estrogen (as would happen with surgical menopause). It can also happen when going through a natural premature menopause. Vaginal Atrophy is a very unpleasant symptom of menopause, particularly if it occurs when you are in your 20s or 30s.
Symptoms of Vaginal Dryness Menopause
Prior to menopause the vaginal lining appears plump, bright red, moist and soft. As estrogen levels decline, the lining of the vagina becomes drier, light pink or bluish in colour and loses elasticity.
• Vaginal dryness before/during sex
• Vaginal discomfort
• Pain during sex
• Vaginal itching and/or burning
• Itching Pruritus Vulvae/Itchy Vulva
• Frequent or recurring vaginal or urinary infections
• Thrush like symptoms
• Lack of bladder control
• Discomfort whilst seated, in tight clothes or when walking or exercising
Other Potential Causes of Vaginal Dryness
• Perimenopause (the transitional stage towards menopause)
• Surgical removal of your ovaries
• Coming off HRT – symptoms can be more severe
• Certain medications – antihistamines, cold medications, antidepressants, cancer treatments
• Smoking and alcohol consumption
• Autoimmune Disease (Sjogren’s Syndrome – attacks healthy tissue)
• Cancer Treatments – effects on the ovaries
• Stress – can cause or increase severity of vaginal dryness
• Anxiety and Depression – can lead to lack of arousal and vaginal dryness
• Relationship problems – can result in decreased lubrication, loss of libido.
• Allergic reactions – chemicals in soap, detergents, hand lotions, oil based products such as petroleum jelly, bubble baths, perfumed products scented and coloured toilet paper
What Can You Do?
If you are experiencing mild vulva irritation or discomfort, stop using soap on the inner parts of your vulva. Clean water is perfectly adequate.
Use only unscented white toilet paper. Wash you underwear in detergents without perfumes, dyes and softeners.
Try over the counter water-based vaginal lubricants to decrease discomfort. You may need to try a number of products to find one that suits you.
Vaginal Moisturisers – may be preferred by women experiencing irritation and burning. You may need to try a number of products to find one that suits you.
Vitamin E Oil & Coconut Oil – can both help to relieve this symptom.
Regular sexual stimulation helps to promote blood flow and helps to maintain vaginal health.
Other techniques such as extended caressing and massage may be more pleasurable than penetration.
Communication between partners.
Alternative therapies such as yoga, meditation can help to reduce stress and anxiety.
Eat a well balanced diet – increase consumption of soy and flaxseed.
Estrogen Replacement Therapy – low-dose vaginal estrogen therapy in the form of gels, tablets or rings can effectively treat vaginal symptoms by delivering estrogen directly to the vagina to restore thickness to the vaginal tissues with minimal absorption to the rest of your body. Low-dose vaginal estrogen therapy can also treat some urinary symptoms.
If you have more severe vaginal dryness and pain or if lubricants and moisturisers are not working for you, seek advice from you Healthcare Professional to rule out any underlying cause and to discuss vaginal estrogen therapy.
Update September 2014
Experts who reviewed the terminology associated with genitourinary tract symptoms related to menopause, currently referred to as vulvo-vaginal atrophy, have agreed that the term genitourinary syndrome of menopause (GSM) is a medically more accurate, all-encompassing and a more publicly acceptable term.
This has been reported in a recent Journal of Sexual Medicine article.
In the future, GSM will encompass a collection of symptoms and signs associated with a decrease in estrogen and other sex hormones and may include genital symptoms of dryness, burning and irritation; sexual symptoms of lack of lubrication, discomfort or pain and impaired function; and urinary symptoms of urgency, dysuria and recurrent urinary tract infections.
Reed SD, Newton KM, LaCroix AZ, Grothaus LC, Grieco VS, Ehrlich K. Vaginal endometrial, and reproductive hormone findings: randomized, placebo-controlled trial of black cohosh, multibotanical herbs, and dietary soy for vasomotor symptoms: the Herbal Alternatives for Menopause (HALT) Study. Menopause. 2008;15(1):51-58.
Vulvovaginal Symptoms. The Changing Body: Menopause Handbook. Retrieved from www.menopause.org
About vaginal dryness. Retrieved from http://www.womens-health-concern.org/help-and-advice/factsheets/focus-series/vaginal-dryness/
Vaginal and Vulvar Comfort: Lubricants, Moisturizers and Low-dose Vaginal Estrogen. Retrieved from http://www.menopause.org/for-women/sexual-health-menopause-online/effective-treatments-for-sexual-problems/vaginal-and-vulvar-comfort-lubricants-moisturizers-and-low-dose-vaginal-estrogen
Vaginal Dryness. (Dec 2012) Retrieved from http://www.mayoclinic.org/diseases-conditions/vaginal-dryness/basics/definition/con-20029192
Menopause/Vaginal Dryness. Retrieved from http://www.dslrf.org/mwh/content.asp?L2=1&L3=3&SID=244
Menopause Symptoms: Vaginal Changes. Retrieved from http://www.breastcancer.org/tips/menopausal/treat/vaginal-changes